What Is IVF Treatment?
Quick Answer
IVF (in vitro fertilization) is a fertility treatment where eggs are retrieved from the ovaries, fertilized with sperm in a laboratory, and the resulting embryo is transferred to the uterus. It is the most effective and widely used form of assisted reproductive technology, with success rates of 40 to 50% per cycle for patients under 35.
Markham Fertility Centre has supported over 12,000 families with IVF since 1990, with pain-free egg retrieval and five clinic locations across Ontario.
How IVF Works
IVF bypasses several natural barriers to conception by handling eggs, sperm, and embryos outside the body. A complete cycle takes 4 to 6 weeks and follows these steps:
- Ovarian stimulation (8 to 14 days): Injectable hormones stimulate the ovaries to produce multiple eggs instead of the single egg that would develop naturally. Blood tests and ultrasounds monitor follicle growth every 2 to 3 days.
- Trigger shot: When follicles reach approximately 18 to 20 mm, an hCG injection triggers final egg maturation. Egg retrieval is scheduled 34 to 36 hours later.
- Egg retrieval: A short outpatient procedure using an ultrasound-guided needle to collect eggs through the vaginal wall. Takes approximately 10 to 15 minutes under sedation.
- Fertilization: Eggs and sperm are combined in the laboratory (conventional IVF) or a single sperm is injected into each egg (ICSI). Fertilization is confirmed the following day.
- Embryo culture (3 to 5 days): Embryos develop in a controlled incubator. Embryologists monitor cell division and grade embryo quality. By day 5, embryos ideally reach the blastocyst stage.
- Embryo transfer: One embryo is placed into the uterus through a thin catheter. The procedure takes a few minutes and requires no sedation.
- Pregnancy test: A blood test approximately 10 to 14 days after transfer measures beta-hCG levels to confirm implantation.
Extra embryos of good quality can be frozen (cryopreserved) for future use, reducing the need for additional full stimulation cycles.
Who Needs IVF
IVF is recommended when other treatments have not been successful or when specific medical conditions make natural conception or simpler treatments unlikely to work:
- Blocked or damaged fallopian tubes
- Severe male factor infertility (low sperm count, poor motility, or abnormal morphology requiring ICSI)
- Advanced reproductive age (typically over 38, when egg quality and quantity decline)
- Failed IUI cycles (usually after 3 to 5 attempts without pregnancy)
- Endometriosis affecting fertility
- Ovulatory disorders that do not respond to medication alone
- Unexplained infertility that persists after initial treatments
- Need for genetic testing (PGT) to screen embryos for chromosomal or genetic abnormalities
- Fertility preservation (egg or embryo freezing for medical or personal reasons)
- Same-sex couples and single individuals using donor gametes or surrogacy
IVF Success Rates by Age
Success depends primarily on the age of the person providing the eggs:
| Age group | Live birth rate per cycle |
| Under 35 | 40 to 50% |
| 35 to 37 | 30 to 40% |
| 38 to 40 | 20 to 30% |
| 41 to 42 | 10 to 20% |
| Over 42 | Below 10% (donor eggs significantly improve rates) |
Data from BORN Ontario shows that nearly 50% of IVF retrieval cycles in the province result in a clinical pregnancy, with rates reaching approximately 60% for patients under 35.
Other factors that influence success include embryo quality, uterine health, sperm quality, and whether preimplantation genetic testing (PGT) is used to select chromosomally normal embryos.
Common Add-On Procedures
IVF can be combined with several techniques to improve outcomes:
| Procedure | Purpose | When it is used |
| ICSI | Single sperm is injected directly into the egg | Severe male factor infertility, low sperm count |
| PGT-A | Screens embryos for chromosomal abnormalities | Patients over 35, recurrent pregnancy loss, recurrent implantation failure |
| PGT-M | Tests embryos for a specific inherited genetic condition | Known carrier status for genetic disorders |
| Assisted hatching | Creates a small opening in the embryo’s shell to aid implantation | Older patients, previously failed transfers |
| Frozen embryo transfer (FET) | Thaws and transfers a previously frozen embryo | When fresh transfer is not optimal or extra embryos exist |
| Donor eggs or sperm | Uses gametes from a screened donor | Diminished ovarian reserve, single individuals, same-sex couples |
IVF Risks and Side Effects
IVF is generally safe, but patients should be aware of potential risks:
- Medication side effects: Bloating, mood swings, headaches, breast tenderness, and injection site discomfort during stimulation
- Ovarian hyperstimulation syndrome (OHSS): A rare but serious condition where the ovaries over-respond to medication. Careful monitoring reduces this risk significantly.
- Multiple pregnancy: Transferring more than one embryo increases the chance of twins or triplets. Single embryo transfer (eSET) is now standard practice to minimize this risk.
- Egg retrieval risks: Mild cramping and spotting are common. Infection or bleeding is extremely rare.
- Emotional toll: The uncertainty, waiting periods, and physical demands of IVF can be stressful. Support from your care team, partner, and mental health professionals is important.
IVF Cost and Funding in Ontario
Ontario offers strong public support for IVF:
- One funded IVF cycle per lifetime through the Ontario Fertility Program (OFP) for eligible residents under 43. Covers monitoring, retrieval, fertilization (including ICSI), embryo freezing, and all transfers from that cycle.
- Medications are not covered and typically cost $3,000 to $7,000 per cycle
- Ontario Fertility Treatment Tax Credit (effective January 2025): 25% of eligible fertility expenses up to $5,000/year, refundable and stackable with federal medical expense credits
- Private IVF cycles cost $10,000 to $15,000 before medications and add-ons
Why Patients in Ontario Choose Markham Fertility Centre for IVF
- Pain-free egg retrieval with an anesthesiologist at every procedure, the only clinic in Ontario to offer this and at no extra cost
- On-site genetics program for PGT-A and PGT-M counselling and testing
- Personalized protocols including conventional, natural cycle, and modified IVF based on your ovarian reserve and diagnosis
- Five locations across Markham, Barrie-Innisfil, Oshawa, Orillia, and Sudbury for convenient monitoring
- Inclusive care for 2SLGBTQIA+ individuals, single patients, and those using donor gametes through a Health Canada-approved program
Start your IVF journey at Markham Fertility Centre →
FAQ
How long does one IVF cycle take?
A complete IVF cycle takes approximately 4 to 6 weeks from the start of ovarian stimulation to the pregnancy test. If a frozen embryo transfer is needed instead of a fresh transfer, the timeline may extend by an additional cycle.
Is IVF painful?
Most steps involve mild discomfort rather than pain. Daily injections during stimulation can cause bruising and soreness. Egg retrieval is performed under sedation. At Markham Fertility Centre, an anesthesiologist is present to ensure a fully pain-free retrieval experience.
How many IVF cycles does it take to get pregnant?
Many patients achieve pregnancy within 1 to 3 cycles. Success depends on age, diagnosis, embryo quality, and whether techniques like PGT are used. Freezing extra embryos during the first cycle can make subsequent attempts less invasive and less expensive.
Is IVF covered by OHIP in Ontario?
One IVF cycle per lifetime is publicly funded through the Ontario Fertility Program for eligible residents under 43. Medications, storage, and genetic testing are out-of-pocket but eligible for the Ontario Fertility Treatment Tax Credit.